Bronchiectatic Disease

a disease of the respiratory organs accompanied by dilatation of the bronchi (bronchiectases), characterized by a prolonged, often progressive course and a tendency toward suppurative complications. Bronchiectasis was first described in 1819 by the French physician R. Laënnec. Bronchiectasis is classified as congenital and acquired. Congenital bronchiectasis may appear as early as the uterine period of development as a result of improper development of the bronchi or in the newborn in case of atelectasis.

Acquired bronchiectasis is caused by inflammatory processes in the area of the bronchial wall and is connected with changes in the musculo-elastic layer of the bronchi in various illnesses (whooping cough, measles, influenza, pneumonia, chronic bronchitis, chronic inflammation of the accessory sinuses of the nose, and others) and also when a bronchus is obstructed by a foreign body.

The most characteristic manifestation of bronchiectatic disease is paroxysmal coughing with sputum that sometimes has an unpleasant odor and contains blood fibers. The expectoration of sputum is rapid and abundant; it may attain a mass of up to 500 g in 24 hours. Sometimes hemoptysis is observed and even hemorrhaging. As bronchiectatic disease progresses, the patient’s terminal phalanges on both hands and feet become thickened, becoming so-called drumsticks, and the nails acquire the look of “watch glasses.” A frequent complication of bronchiectatic disease is focal inflammation of the lungs; in advanced cases cardiac insufficiency develops and kidney damage is possible.

Treatment and prophylaxis are directed toward increasing the body’s resistance and fighting infection and sometimes by excising its focus (surgical treatment).